Effectiveness of Cognitive Behavioural Self-Help for the Treatment of Depression and Anxiety in People with Long-Term Physical Health Conditions: a Systematic Review and Meta-Analysis of Randomised Controlled Trials

Abstract

Background: Depression and anxiety are prevalent comorbidities in people with long-term physical health conditions; however, there is limited access to evidence-based treatments for comorbid mental health difficulties. Purpose: This study is a meta-analysis examining the effectiveness of cognitive behavioural self-help for physical symptoms, depression and anxiety in people with long-term conditions. Methods: This study involves a systematic search of electronic databases supplemented by expert contact, reference and citation checking and grey literature. Results: The meta-analysis yielded a small effect size for 11 studies reporting primary outcomes of depression (g = −0.20) and 8 studies anxiety (g = −0.21) with a large effect size (g = −1.14) for 1 study examining physical health symptoms. There were no significant moderators of the main effect. Conclusions: Limited evidence supports cognitive behavioural self-help for depression, anxiety and physical symptoms in people with long-term conditions. Small effect sizes for depression and anxiety may result from failure to recruit participants with clinical levels of these difficulties at baseline.